Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO-0001582 | FL |
NPI | 1235135138 |
---|---|
Provider Name | Eugene Arthur Fox |
First Address | Hialeah, FL 33012-3726 |
Second Address | Hialeah, FL 33012-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 11/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029649000 | (05) | FL |
T88566 | (02) |